Surgery support device, surgery support system and program

Abstract

To provide a surgical operation support device, a surgical operation support system and a program which can perform operation support of the orthopedic surgical operation with high accuracy at low cost.SOLUTION: A surgical operation support device being the surgical operation support device used in such a state that a positional relation with an implant is fixed in artificial joint replacement, comprises: an imaging unit; a horizontal surface detection unit; a posture detection unit; a feature point calculation unit which calculates position information indicating spatial positions of two feature points on the basis of a photographed image obtained by imaging a surgical field including the two feature points for defining one axis of a reference coordinate system by the imaging unit; a calibration unit which sets the reference coordinate system on the basis of the position information of the feature points and horizontal surface information; a posture calculation unit which calculates a posture of an implant in the reference coordinate system on the basis of the posture of the surgical operation support device; and a display unit which displays the posture of the implant as support information.SELECTED DRAWING: Figure 6

Description

[Technical field]

[0001] The present invention relates to a surgical assistance device, a surgical assistance system, and a program for assisting a surgical operation, particularly an orthopedic surgical operation for installing an orthopedic implant in a patient's body. [Background technology]

[0002] Conventionally, replacement surgery has been known to replace hip joints, knee joints, etc. with implants (artificial joints) made of metal or ceramics. When attaching these implants to a predetermined position in the body, it is important to install them at the optimal angle and position.

[0003] In recent years, preoperative planning has been performed using medical tomographic images of the patient's implant installation site to select the shape and size of the implant to be installed, simulate the installation angle, and, if necessary, the amount and position of bone resection, etc. Also, a surgical navigation system has been proposed that provides the surgeon with support information such as the installation angle during surgery so that the implant can be installed according to the preoperative plan (for example, see Patent Document 1).

[0004] Patent Document 1 discloses an installation angle measuring device that provides the operator with the installation angle (exoversion angle and anteversion angle) of the acetabular cup during total hip arthroplasty (THA). Specifically, in Patent Document 1, a rectangular parallelepiped installation angle measuring device is placed on the operating table so that the display surface is parallel to the patient's body axis, and calibration is performed with this state as a reference state (exoversion angle 0°, anteversion angle 0°). Then, based on the orientation of the installation angle measuring device fixed to the cup holder, the exoversion angle and anteversion angle during surgery are measured, and the installation angle of the acetabular cup is adjusted (registered) while referring to the measurement result. [Prior art documents] [Patent documents]

[0005] [Patent Document 1] JP 2019-72242 A Summary of the Invention [Problem to be solved by the invention]

[0006] However, in the method disclosed in Patent Document 1, when performing calibration, the only way is to visually check whether the display surface of the device body is parallel to the body axis, and this may lack accuracy depending on the practitioner's experience and skill. Therefore, the accuracy of the measured installation angle is not high, and there is a risk that registration cannot be performed according to the preoperative plan.

[0007] An object of the present invention is to provide a surgery support device, a surgery support system, and a program that are capable of providing intraoperative support for orthopedic surgery with high accuracy and at low cost. [Means for solving the problem]

[0008] The surgical support device according to the present invention comprises: A surgical assistance device for use in artificial joint replacement surgery, comprising: An imaging unit that images a surgical field; A horizontal plane detection unit capable of detecting a horizontal plane; a device orientation detection unit capable of detecting an orientation of the surgery support device; A target position calculation unit that calculates position information indicating a spatial position of the target based on an image captured by the imaging unit of a surgical field including a target for defining one axis of a reference coordinate system; a calibration unit that sets the reference coordinate system based on the position information obtained by the target position calculation unit and the horizontal plane information obtained by the horizontal plane detection unit; Using the orientation information of the surgery support device detected by the device orientation detection unit, Rui A posture calculation unit for calculating a posture of the implant; a display unit that displays the calculated posture of the implant as support information; Equipped with.

[0009] The surgical support system according to the present invention comprises: The above-mentioned surgical assistance device, The surgical support device includes a patient posture detection device configured to be able to communicate with the surgical support device and providing patient posture information to the surgical support device.

[0010] The program according to the present invention comprises: The computer of the surgical support device used in artificial joint replacement surgery A process of calculating position information indicating a spatial position of a target for defining one axis of a reference coordinate system based on a captured image of a surgical field including the target; A process of acquiring horizontal plane information indicating a horizontal plane; A process of setting the reference coordinate system based on the position information and the horizontal plane information; Using the posture information of the surgery support device, Rui A process of calculating the posture of the implant; A process of displaying the calculated posture of the implant as support information; Execute the command. Effect of the Invention

[0011] According to the present invention, intraoperative assistance during surgical operations can be performed with high precision and at low cost. [Brief description of the drawings]

[0012] [Figure 1] FIG. 1 is a diagram showing an example of an implant used in total hip replacement surgery. [Diagram 2] 2A and 2B are diagrams showing an example of a usage form of a surgery support device according to an embodiment. [Diagram 3] 3A and 3B are diagrams showing the relationship between the forward opening angle and the outward opening angle and the reference coordinate system. [Figure 4] FIG. 4 is a block diagram showing a functional configuration of the first surgery support terminal. [Diagram 5] FIG. 5 is a block diagram showing a functional configuration of the second surgery support terminal. [Figure 6] FIG. 6 is a flowchart showing an example of a surgery navigation process executed by the control unit of the first surgery support terminal. [Figure 7] FIG. 7 is a diagram showing a surgical procedure in the lateral position. [Figure 8] FIG. 8 is a diagram showing an example of how support information is displayed. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0013] DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS Hereinafter, an embodiment of the present invention will be described in detail with reference to the drawings. In this embodiment, a case where a surgery support system 1 is used for total hip arthroplasty (THA) will be described.

[0014] First, an implant 100 used in total hip replacement surgery will be described with reference to Fig. 1. As shown in Fig. 1, the implant 100 is composed of an acetabular cup 101, a liner 102, an inner head 103, and a stem 104.

[0015] The acetabular cup 101 has a hollow hemispherical shape. The acetabular cup 101 is fixed to the acetabulum and serves as an acetabulum. The acetabular cup 101 is made of a metal material such as a titanium alloy or a cobalt chromium alloy.

[0016] The liner 102 has a hollow hemispherical shape that is slightly smaller than the acetabular cup 101. The liner 102 is fixed to the inside of the acetabular cup 101. The liner 102 is interposed between the acetabular cup 101 and the inner head 103, and serves as cartilage that suppresses wear. The liner 102 is formed of a resin material such as polyethylene.

[0017] The inner head 103 has a spherical shape. The inner head 103 is slidably attached to the liner 102 and serves as a femoral head. The inner head 103 is made of, for example, a metal material such as a titanium alloy or a cobalt chromium alloy, or a ceramic material such as alumina or zirconia.

[0018] The stem 104 is a base that is inserted into the medullary cavity of the femur, and an inner head 103 is attached to the end portion exposed from the femur. The stem 104 is made of a metal material such as titanium or a titanium alloy.

[0019] In total hip replacement surgery, it is important that the acetabular cup 101 is fixed in an appropriate position relative to the acetabulum in order to prevent problems such as dislocation after surgery. The position of the acetabular cup 101 is determined, for example, by the installation angle (anteversion angle RA and exoversion angle RI) relative to the acetabulum. In general, it is considered preferable that the anteversion angle RA is 15 to 20° and the exoversion angle RI is 40 to 45°. The anteversion angle RA and the exoversion angle RI may be set in advance in a preoperative plan based on an X-ray image or a CT image of the pelvis.

[0020] When placing an acetabular cup 101 in the acetabulum of a patient P in a supine or lateral position, the surgery support system 1 provides the surgeon with the placement angle of the acetabular cup 101 during surgery as support information via the first surgery support terminal 10.

[0021] 2A and 2B are diagrams showing an example of a usage form of the surgery support system 1. Fig. 2A shows a state in which a patient P on an operating table T is viewed from the side, and Fig. 2B shows a state in which the patient P is viewed from above. Figs. 2A and 2B show a case in which the patient P is in a supine position.

[0022] 2A and 2B, the surgery support system 1 includes a first surgery support terminal 10 and a second surgery support terminal 20. The first surgery support terminal 10 and the second surgery support terminal 20 may each be, for example, a mobile terminal such as a smartphone or tablet on which a specific application program is installed.

[0023] When performing total hip replacement surgery on a patient P, the first surgery support terminal 10 is used in a state in which its positional relationship with the implant 100 is fixed. Specifically, the first surgery support terminal 10 is used by being fixed to a rod-shaped cup holder 105 for placing an acetabular cup 101 in the acetabulum. The first surgery support terminal 10 is fixed in a predetermined orientation, for example, based on the axial direction AX of the cup holder 105. The orientation of the first surgery support terminal 10 is expressed, for example, in an orthogonal coordinate system in which the length, width, and thickness directions of a rectangular display surface are the three axes.

[0024] Based on the attitude of the first surgery support terminal 10, the attitude of the cup holder 105, i.e., the attitude of the acetabular cup 101, may be derived by calculation, and the mounting attitude of the first surgery support terminal 10 to the cup holder 105 is not particularly limited. For example, when performing registration of the acetabular cup 101, the first surgery support terminal 10 may be fixed to the cup holder 105 in a position that allows the surgeon to easily view the display surface of the first surgery support terminal 10. Also, for example, when the first surgery support terminal 10 is mounted to the cup holder 105 so that the display surface of the first surgery support terminal 10 is perpendicular to the axial direction or parallel to the axial direction, one axis that defines the attitude of the first surgery support terminal 10 coincides with the axial direction of the acetabular cup 101, so that the calculation load for deriving the attitude of the acetabular cup 101 can be reduced.

[0025] The cup holder 105 is attached to the cup tray side (opposite the outer surface that contacts the acetabulum) of the acetabular cup 101. Usually, the normal to the tangent plane at the center point of the outer surface of the acetabular cup 101 (hereinafter referred to as the "cup installation surface normal") coincides with the axial direction AX of the cup holder 105. After the acetabular cup 101 is oriented to a predetermined installation angle, it is fitted into the acetabulum by striking the cup holder 105 and fixed by a fixing member such as a screw.

[0026] In this embodiment, a functional pelvic plane (FPP) that takes into account the pelvic inclination in a supine or standing position is used as a reference plane for measuring the installation angle of the acetabular cup 101. The installation angle of the acetabular cup 101 is expressed by a radiographic definition. The installation angle of the acetabular cup 101 may be expressed by an anatomical definition or an operative definition.

[0027] The installation angle of the acetabular cup 101 is expressed using a reference coordinate system in which the medial-lateral direction is the X-axis, the normal direction of the functional pelvic plane is the Y-axis, and the distal-proximal direction (body axis direction) is the Z-axis. Specifically, the anteversion angle RA is expressed as the angle between the vector of the cup installation surface normal projected onto the XZ plane (functional pelvic plane) and the cup installation surface normal (see FIG. 3A). When the cup installation surface normal is parallel to the XZ plane, the anteversion angle RA is 0°. The exoversion angle RI is expressed as the angle between the vector of the cup installation surface normal projected onto the XZ plane and the Z axis. When the cup installation surface normal is perpendicular to the Z axis, the exoversion angle RI is 90° (see FIG. 3B).

[0028] In this embodiment, when acquiring information about the functional pelvic plane for setting the reference coordinate system, the functional pelvic plane of the patient P in the supine position is considered to be parallel to the operating table T, i.e., parallel to the horizontal plane. In other words, the normal direction of the horizontal plane is set as the Y-axis of the reference coordinate system.

[0029] In addition, the fact that the straight line connecting the left and right anterior superior iliac spines is approximately aligned in the medial-lateral direction is utilized. In other words, the straight line connecting the left and right anterior superior iliac spines is set as the X-axis, and the axis perpendicular to the X-axis and Y-axis is set as the Z-axis.

[0030] Coordinate information indicating the spatial positions of the left and right anterior superior iliac spines is acquired, for example, based on a captured image of the AR marker 106. A known technique can be applied to an algorithm for deriving the spatial coordinates of the feature points (here, the left and right anterior superior iliac spines) from the captured image of the AR marker 106. For example, the first surgery support terminal 10 is configured to derive the spatial coordinates of the feature points indicated by the AR marker 106 based on the position, size, and attitude (tilt) of the AR marker 106 drawn in the captured image.

[0031] By setting a reference coordinate system based on the spatial coordinates of the left and right anterior superior iliac spines of patient P and the functional pelvic plane and calibrating the first surgical support terminal 10, the installation angle (anterior opening angle RA and lateral opening angle RI) of the acetabular cup 101 during surgery can be derived based on the posture of the first surgical support terminal 10 in the reference coordinate system.

[0032] The practitioner can perform registration while referring to the installation angle of the acetabular cup 101 provided by the first surgery support terminal 10, thereby fixing the acetabular cup 101 to the acetabulum at an optimal installation angle.

[0033] Fig. 4 is a block diagram showing the functional configuration of the first surgery support terminal 10. As shown in Fig. 4, the first surgery support terminal 10 includes a control unit 11, a storage unit 12, a gyro sensor 13, an acceleration sensor 14, an imaging unit 15, an operation unit 16, a display unit 17, and a communication unit 18.

[0034] The control unit 11 includes a CPU as a calculation / control device, a ROM as a main memory device, and a RAM (all symbols omitted). A basic program and basic setting data are stored in the ROM. The CPU centrally controls the operation of each block of the first surgery support terminal 10 by, for example, reading a program corresponding to the processing content from the ROM, expanding it in the RAM, and executing the expanded program.

[0035] Some or all of the processing performed by the control unit 11 may be executed by electronic circuits such as a digital signal processor (DSP), an application specific integrated circuit (ASIC), or a programmable logic device (PLD) provided according to the processing.

[0036] The memory unit 12 is, for example, an internal storage (auxiliary storage device) such as a flash memory, and stores programs, various data, and the like. In this embodiment, a surgical navigation program is stored in the memory unit 12. The memory unit 12 also stores data indicating a correlation between the posture of the first surgical support terminal 10 and the posture of the acetabular cup 101. The surgical navigation program and the like may be stored in a ROM. The memory unit 12 may also store preoperative planning data acquired from a hospital terminal (not shown) via the communication unit 18.

[0037] The gyro sensor 13 functions as a device attitude detection unit that detects the attitude of the first surgery support terminal 10. The acceleration sensor 14 functions as a horizontal plane detection unit that detects a horizontal plane. The gyro sensor 13 and the acceleration sensor 14 may be combined and applied to the horizontal plane detection unit and / or the device attitude detection unit.

[0038] The imaging unit 15 has a lens, an image sensor, an imaging control unit, and the like, and captures an image of a subject (here, an operating field on an operating table T) in response to an operation of the operation unit 16 (shutter button).

[0039] The operation unit 16 and the display unit 17 are configured, for example, with a flat panel display with a touch panel. As the flat panel display, a liquid crystal display, an organic EL display, etc. can be used. The operation unit 16 also includes a power button for turning the power on and off, a shutter button for issuing an image capture command, buttons for selecting and issuing commands for various modes and functions, etc. (all of which are not shown).

[0040] The operation unit 16 accepts an operation for causing the first surgery support terminal 10 to execute a predetermined operation, and outputs an operation signal corresponding to the operation to the control unit 11. The control unit 11 causes each unit to execute a predetermined operation (e.g., capturing an image of a subject, etc.) according to the operation signal from the operation unit 16.

[0041] The display unit 17 displays various information under the control of the control unit 11. For example, the display unit 17 displays an application screen in accordance with the execution of various application programs by the control unit 11. In the present embodiment, the display unit 17 displays a screen for surgical navigation. Specifically, the display unit 17 displays the anteversion angle RA and the lateral opening angle RI as support information in artificial joint replacement surgery, and provides them to the practitioner.

[0042] The communication unit 18 is, for example, a communication interface such as a wireless LAN. The control unit 11 transmits and receives various information to and from a second surgery support terminal 20 connected to a network via the communication unit 18. In addition, for example, the control unit 11 may be configured to transmit and receive various information to and from a hospital terminal (not shown) connected to the network or a server on the cloud via the communication unit 18. A communication interface for short-range wireless communication such as Bluetooth (registered trademark) can also be applied to the communication unit 18.

[0043] The control unit 11 functions as a feature point calculation unit, a calibration unit, and a posture calculation unit by executing a surgical navigation program stored in the ROM or the storage unit 12. These functions will be described in detail with reference to the flowchart of FIG.

[0044] Fig. 5 is a block diagram showing the functional configuration of the second surgery support terminal 20. As shown in Fig. 5, the second surgery support terminal 20 includes a control unit 21, a memory unit 22, a gyro sensor 23, an acceleration sensor 24, an operation unit 26, a display unit 27, and a communication unit 28. The functions of each unit are the same as those of the first surgery support terminal 10, and therefore the description thereof will be omitted.

[0045] The second surgery support terminal 20 is used in a state where its positional relationship with the patient P is fixed when performing an artificial hip replacement surgery on the patient P. For example, a small wearable terminal such as a smart watch that does not impede the artificial joint replacement surgery is suitable for the second surgery support terminal 20. The second surgery support terminal 20 is attached to the back of the patient P by a belt or the like while being protected by a cushioning material made of, for example, urethane resin.

[0046] In the second surgery support terminal 20, the gyro sensor 23 functions as a patient posture detection unit capable of detecting the posture of the patient P. The gyro sensor 23 and the acceleration sensor 24 may be used in combination to detect the patient posture. The posture information of the patient P obtained by the second surgery support terminal 20 is transmitted to the first surgery support terminal 10. The first surgery support terminal 10 sets a reference coordinate system in consideration of the posture information of the patient P provided from the second surgery support terminal 20.

[0047] 6 is a flowchart showing an example of a surgical navigation process executed by the control unit 11 of the first surgical support terminal 10. This process is realized, for example, by the CPU executing a surgical navigation program stored in the storage unit 12 in response to an operation to start up a surgical navigation application input via the operation unit 16.

[0048] In addition, when performing total hip replacement surgery, a preoperative planning process is performed in advance to determine the target anteversion angle RA and exoversion angle RI. The anteversion angle RA and exoversion angle RI are stored in the storage unit 12 as preoperative planning data, and may be used to automatically determine whether the installation angle is appropriate.

[0049] In the surgical navigation process, the reference coordinate system is set with the patient P in a supine position. The AR markers 106 are attached so as to point to the left and right anterior superior iliac spines of the patient P. In addition, as the surgical navigation program is executed, the imaging unit 15 starts imaging. During surgery, patient posture information is constantly provided from the second surgical support terminal 20 to the first surgical support terminal 10.

[0050] In step S101, the control unit 11 acquires a captured image captured by the imaging unit 15. The practitioner adjusts the position and posture of the first surgery support terminal 10 so that the captured image includes images of the two AR markers 106. When capturing an image of the AR markers 106, the first surgery support terminal 10 does not need to be fixed.

[0051] In step S102, the control unit 11 analyzes the captured image and calculates position information (hereinafter referred to as "feature point information") indicating the spatial positions of the feature points (function as a "feature point calculation unit"). For example, the control unit 11 calculates feature point information of two feature points (anterior superior iliac spine) based on the size and inclination of the pattern of the AR marker 106 included in the captured image. By using the AR marker 106, the pattern can be accurately identified and the position and posture of the AR marker 1 can be accurately detected, so that the positions of the feature points can be accurately identified.

[0052] In step S103, the control unit 11 acquires the horizontal plane information provided by the acceleration sensor .

[0053] In step S104, the control unit 11 sets a reference coordinate system based on the feature point information calculated in step S102 and the horizontal plane information acquired in step S103 (functioning as a "calibration unit"). The functional pelvic plane of the patient P in the supine position can be considered to be parallel to the operating table T, i.e., parallel to the horizontal plane. In addition, the straight line connecting the left and right anterior superior iliac spines approximately coincides with the medial-lateral direction of the patient P. Therefore, an appropriate reference coordinate system can be set based on the feature point information and the horizontal plane information.

[0054] For example, a reference coordinate system is set with the normal direction of the horizontal plane as the Y axis, the straight line connecting two feature points (the left and right anterior superior hyperostites) as the X axis, and the axis perpendicular to the X and Y axes as the Z axis. If the straight line connecting the two feature points is inclined with respect to the horizontal plane, the XZ plane indicating the functional pelvic plane is corrected based on the inclination angle.

[0055] In step S105, the control unit 11 determines whether or not the posture of the patient P has changed based on the patient posture information provided from the second surgery support terminal 20. If the posture of the patient P has changed ("YES" in step S105), the process proceeds to step S106. If the posture of the patient P has not changed ("NO" in step S105), the process proceeds to step S107.

[0056] In step S106, the control unit 11 corrects the reference coordinate system based on the patient's posture (functions as a "calibration unit"). When performing total hip replacement surgery in the supine position, the posture of the patient P does not change, so correction of the reference coordinate system is not necessary. On the other hand, when performing total hip replacement surgery in the lateral position, for example, the posture of the patient P rotates approximately 90° on the XY plane, and the reference coordinate system also changes (see FIG. 7). Therefore, the reference coordinate system set in step S104 is corrected according to the change in the posture of the patient P.

[0057] Through the above process, the reference coordinate system for the patient P is appropriately set. After the setting of the reference coordinate system is completed, the first surgery support terminal 10 is fixed to the cup holder 105 in a predetermined orientation. The "predetermined orientation" is an orientation that allows the orientation of the cup holder 105, i.e., the orientation of the acetabular cup 101, to be derived by calculation based on the orientation of the first surgery support terminal 10. For example, the first surgery support terminal 10 is fixed to the cup holder 105 so that the axial direction AX of the cup holder 105 is perpendicular to the display surface.

[0058] In step S107, the control unit 11 acquires the device attitude information of the first surgery supporting terminal 10 provided by the gyro sensor 13.

[0059] In step S108, the control unit 11 calculates the installation angle (anterior opening angle RA and lateral opening angle RI) of the acetabular cup 101 during surgery based on the set reference coordinate system and the device attitude information of the first surgery support terminal 10.

[0060] In step S109, the control unit 11 controls the operation of the display unit 17 to display the anteversion angle RA and the exoversion angle RI as support information (see FIG. 8). The practitioner recognizes the current installation angle of the acetabular cup 101 from the support information displayed on the display unit 17. In FIG. 8, the anteversion angle RA and the exoversion angle RI are displayed numerically, and the postures of the acetabular cup 101 and the cup holder 105 in the reference coordinate system are graphically shown. This allows the practitioner to intuitively determine whether the current installation angle is appropriate, and the operation that should be performed to obtain the optimal installation angle (such as how much it should be rotated in the front-back and / or left-right directions).

[0061] In step S110, the control unit 11 determines whether or not an operation to end the surgical navigation application has been performed based on an operation signal from the operation unit 16. If an operation to end the application has been performed ("YES" in step S110), the surgical navigation process ends. If an operation to end the application has not been performed ("NO" in step S110), the process proceeds to step S107. That is, until the end of the surgery, the installation angle is updated and displayed on the display unit 17 of the first surgical support terminal 10 in accordance with the orientation of the cup holder 105.

[0062] Finally, when the installation angle displayed on the display unit 17 matches the preoperative plan, the acetabular cup 101 is fitted into the acetabulum by striking the cup holder 105, and is fixed by a fixing member such as a screw.

[0063] In the above embodiment, the practitioner himself judges whether the installation angle is appropriate while checking the installation angle displayed on the display unit 17, but the first surgical support terminal 10 may automatically judge whether the installation angle is appropriate and notify the practitioner that the optimal installation angle has been reached by a change in the display mode on the display unit 17 (for example, a change in display color) or by voice.

[0064] The first surgery support terminal 10 (surgery support device) according to this embodiment has the following features either alone or in appropriate combination.

[0065] That is, the first surgical support terminal 10 is a surgical support device used in artificial joint replacement surgery with a fixed positional relationship with the implant 100, and includes an imaging unit 15 that images the surgical field, an acceleration sensor 14 (horizontal plane detection unit) that can detect a horizontal plane, a gyro sensor 13 (device attitude detection unit) that can detect the attitude of the first surgical support terminal 10, and a control unit that calculates position information indicating the spatial positions of the two feature points based on an image captured by the imaging unit 15 of a surgical field including two feature points for defining one axis of a reference coordinate system. The control unit 11 (feature point calculation unit) sets a reference coordinate system based on position information of the feature points obtained by the control unit 11 and horizontal plane information obtained by an acceleration sensor 14, a control unit 11 (attitude calculation unit) calculates the attitude (outward opening angle RI, anterior opening angle RA) of the implant 100 in the reference coordinate system based on the attitude of the first surgical support terminal 10 detected by a gyro sensor 13, and a display unit 17 displays the calculated attitude of the implant 100 as support information.

[0066] Since a general-purpose mobile terminal such as a smartphone can be applied to the first surgery support terminal 10, intraoperative support for orthopedic surgery can be performed with high accuracy and at low cost. In addition, since the reference coordinate system is set based on the horizontal plane information obtained by the first surgery support terminal 10, the intraoperative measurement information required for setting the reference coordinate system can be reduced, and low invasiveness can be achieved.

[0067] In the first surgery support terminal 10, the imaging unit 15 captures an image of the AR marker 106 indicating the feature point, and the control unit 11 (feature point calculation unit) calculates position information of the feature point based on the appearance of the AR marker 106 obtained from the captured image.

[0068] The first surgery support terminal 10 is a surgery support device used in a state where the positional relationship with the acetabular cup 101 is fixed during total hip replacement surgery, and the support information includes the lateral opening angle RI and the anterior opening angle RA of the acetabular cup 101.

[0069] The landmarks are the left and right anterior superior iliac spines.

[0070] The horizontal plane detection section and the device attitude detection section are configured with a gyro sensor 13, an acceleration sensor 14, or a combination of the gyro sensor 13 and the acceleration sensor 14.

[0071] The first surgery support terminal 10 includes a communication unit 18 capable of communicating with a second surgery support terminal 20 (patient posture detection device) capable of detecting the posture of the patient P, and the control unit 11 (calibration unit) corrects the reference coordinate system based on the patient posture information provided from the second surgery support terminal 20. This makes it possible to provide appropriate support information even if the posture of the patient P changes after the reference coordinate system is set based on the horizontal plane information and the position information of the feature points. For example, even when performing total hip replacement surgery in the lateral position, the current installation angle of the acetabular cup 101 can be appropriately derived and provided to the surgeon.

[0072] The surgical support system 1 of this embodiment comprises a first surgical support terminal 10 (surgery support device) and a second surgical support terminal 20 (patient posture detection device) configured to communicate with the first surgical support terminal 10 and providing posture information of patient P to the first surgical support terminal 10.

[0073] The surgical support program of this embodiment causes a computer of a first surgical support terminal 10 (surgery support device) used in artificial joint replacement surgery with its positional relationship with the implant 100 to execute the following processes: calculating position information indicating the spatial positions of two characteristic points based on an image captured when a surgical field including two characteristic points for defining one axis of a reference coordinate system (steps S101 and S102 in FIG. 6); acquiring horizontal plane information indicating the horizontal plane (step S103); setting a reference coordinate system based on the position information and the horizontal plane information (step S104); calculating the orientation of the implant 100 in the reference coordinate system based on the orientation of the first surgical support terminal 10 (steps S107 and S108); and displaying the calculated orientation of the implant 100 as support information (step S109).

[0074] The surgery assistance program is provided, for example, via a computer-readable portable storage medium (including, for example, an optical disk, a magneto-optical disk, and a memory card) in which the program is stored. In addition, for example, the surgery assistance program may be provided by downloading the program from a server that holds the program via a network.

[0075] The invention made by the inventor has been specifically described above based on an embodiment, but the present invention is not limited to the above embodiment and can be modified within the scope of the gist of the invention.

[0076] For example, the surgical support device disclosed herein can be applied not only to total hip joint replacement surgery, but also to total knee joint replacement surgery and other total joint replacement surgeries, when setting the installation angle of an implant using a reference plane parallel to the horizontal plane.

[0077] In the embodiment, a case has been described in which the first surgery support terminal 10 (surgery support device) and the second surgery support terminal 20 (patient posture detection device) are used as the surgery support system 1, but the first surgery support terminal 10 may be used alone without using the second surgery support terminal 20. For example, when performing artificial joint replacement surgery in the supine position, the posture of the patient P does not change after the reference coordinate system is set, so the second surgery support terminal 20 is not necessary.

[0078] The embodiments disclosed herein should be considered to be illustrative and not restrictive in all respects. The scope of the present invention is defined by the claims, not the above description, and is intended to include all modifications within the meaning and scope of the claims. [Explanation of symbols]

[0079] 1. Surgical support system 10 First surgery support terminal (surgery support device) 11 Control unit (feature point calculation unit, calibration unit, orientation calculation unit) 12 Storage section 13 Gyro sensor (horizontal plane detection section, device attitude detection section) 14 Acceleration sensor (horizontal plane detection section, device attitude detection section) 15 Imaging unit 16 Control section 17 Display section 18 Communications Department 20 Second surgery support terminal (patient posture detection device) 100 Implants 101 Acetabular cup RA forward opening angle RI outward opening angle

Claims

1. A surgical assistance device for use in artificial joint replacement surgery, comprising: An imaging unit that images a surgical field; A horizontal plane detection unit capable of detecting a horizontal plane; a device orientation detection unit capable of detecting an orientation of the surgery support device; a target position calculation unit that calculates position information indicating a spatial position of the target based on an image captured by the imaging unit of a surgical field including a target for defining one axis of a reference coordinate system; a calibration unit that sets the reference coordinate system based on the position information obtained by the target position calculation unit and the horizontal plane information obtained by the horizontal plane detection unit; a posture calculation unit that calculates a posture of the implant in the reference coordinate system by using posture information of the surgery support apparatus detected by the apparatus posture detection unit; a display unit that displays the calculated posture of the implant as support information; A surgical support device comprising:

2. The implant is used in a fixed position. The surgical support device according to claim 1 .

3. The targets are two feature points: The surgery support device according to claim 1 or 2.

4. The imaging unit captures an image of a marker indicating the feature point, The target position calculation unit calculates the position information based on how the marker appears in the captured image. The surgery support device according to claim 3.

5. The implant is an acetabular cup for use in hip replacement surgery; The support information includes an lateral opening angle and an anteversion angle of the acetabular cup. The surgery support device according to claim 3.

6. The feature points are the left and right anterior superior iliac spines. The surgical support device according to claim 5.

7. The horizontal plane detection unit and the device attitude detection unit are configured with a gyro sensor, an acceleration sensor, or a combination of a gyro sensor and an acceleration sensor. The surgery support device according to claim 1 or 2.

8. A patient posture detection device is provided, the patient posture detection device being capable of detecting the posture of the patient, and a communication unit capable of communicating with the patient posture detection device is provided. The calibration unit corrects the reference coordinate system based on patient posture information provided by the patient posture detection device. The surgery support device according to claim 1 or 2.

9. The surgery support device according to claim 8 , A patient posture detection device configured to be able to communicate with the surgery support device and providing patient posture information to the surgery support device. Surgical support system.

10. The computer of the surgical support device used in artificial joint replacement surgery A process of calculating position information indicating a spatial position of a target for defining one axis of a reference coordinate system based on a captured image of a surgical field including the target; A process of acquiring horizontal plane information indicating a horizontal plane; A process of setting the reference coordinate system based on the position information and the horizontal plane information; calculating a posture of the implant in the reference coordinate system using posture information of the surgical support device; A process of displaying the calculated posture of the implant as support information; A program to execute.

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